There is so much misinformation about sexual intercourse during pregnancy that clinicians often marvel at the highly imaginative questions which their patients ask. Because sex is an important part of your life, let’s look objectively at the facts.

During a normal pregnancy, sexual relations are not harmful. If there is no bleeding and your membranes have not ruptured, intercourse anytime during your pregnancy is desirable, permissible and safe. The rule of moderation should also be followed.

Of course, the woman’s body is changing shape, so some adjustments may be required from your normal habits, and pregnancy is even good time to experiment with the new sexual positions. Because of the changes in the woman, the standard position in which the male is above the female may need modification; it may be more comfortable for the female to assume the position above the male. Or side entry, rear entry, or other positions can be tried to satisfy individual needs.

Caution: Air should not be forced into the vagina at anytime. Although it is rare, an air embolism can occur. During pregnancy there is an increase in blood flow, and air passing into the uterus, can enter the blood stream and cause serious problems. Sex play is alright as long as you observe this restriction.

There is no rules concerning frequency of sexual intercourse; you must simply consider your own physical desire and use your mature thinking. Interestingly, it has been discovered that some women experience heightened sexual desire during pregnancy because of increase in their female hormones. Having an orgasm is not harmful in any way, and in fact, knowing that you do not have to fear becoming pregnant tends to increase the sexual enjoyment.

More than ever before, it is important for both parents to remain faithful to each other (monogamous relationship) because there are greater risks involved with sexually transmitted diseases. Such diseases can be dangerous to both the mother and fetus. Beyond these simple guidelines, any further questions about the practice of sexual activities should be discussed with your clinician. Have an open, candid discussion with her. In the last four weeks of pregnancy, it may be desirable to limit some sexual relations, but only rarely it is necessary to completely abstain from sex at any time during pregnancy.

When It's Not Safe

There are two types of sexual behavior that aren't safe for any pregnant woman:

• If you engage in oral sex, your partner should not blow air into your vagina. Blowing air can cause an air embolism (a blockage of a blood vessel by an air bubble), which can be potentially fatal for mother and child.
• You should not have sex with a partner whose sexual history is unknown to you or who may have a sexually transmitted disease, such as herpes, genital warts, chlamydia, or HIV. If you become infected, the disease may be transmitted to your baby, with potentially dangerous consequences.

If your doctor, nurse-midwife, or other pregnancy health care provider anticipates or detects certain significant complications with your pregnancy, he or she is likely to advise against sexual intercourse. The most common risk factors include:

• a history or threat of miscarriage
• a history of pre-term labor (you've previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)
• unexplained vaginal bleeding, discharge, or cramping
• leakage of amniotic fluid (the fluid that surrounds the baby)
• placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is situated down so low that it covers the cervix (the opening of the uterus)
• incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery
• multiple fetuses (you're having twins, triplets, etc.)

When to Call Your Doctor

Call your health care provider if you're unsure whether sex is safe for you. Also, call if you notice any unusual symptoms after intercourse, such as pain, bleeding, or discharge, or if you experience contractions that seem to continue after sex.

Remember, "normal" is a relative term when it comes to sex during pregnancy. You and your partner need to discuss what feels right for both of you.